Taipei, Taiwan (Bioreports)New arrivals to Taiwan might be forgiven for thinking they’ve stepped back in time.
On the streets of the island’s capital, Taipei, pedestrians appear more concerned with staying out of the hot midday sun than maintaining any semblance of social distancing. Large lines stretch along the sidewalks, as people cram into popular lunchtime eateries. And in nearby parks, large groups of young people exercise and practice dance routines.
In fact, there are few if any visible signs that this is 2020 and the world is in the grip of a raging pandemic.
As the global number of confirmed Covid-19 cases surpasses 30 million, residents of Taipei seem relaxed in the knowledge there has been only one suspected case linked to local transmission in the city since mid-April.
And in Taiwan as a whole, an island with a population of approximately 23 million people, there have been around 500 confirmed cases and just 7 deaths since the beginning of the pandemic.
And that’s despite it being located just 130 kilometers (81 miles) from China, the country where the virus was first detected.
The Secret of success
One of the main reasons for Taiwan’s success in containing the virus is speed.
The island’s leaders were quick to act as rumors spread online of an unidentified virus in the Chinese city of Wuhan and unconfirmed reports of patients having to isolate.
Taiwan’s Foreign Minister Joseph Wu told Bioreports the deadly outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003 had taught them a lot. “At the time Taiwan was hit very hard and then we started building up our capacity dealing with a pandemic like this,” said Wu.
“So, when we heard that there were some secret pneumonia cases in China where patients were treated in isolation, we knew it was something similar.”
Even before Beijing publicly acknowledged the gravity of the virus, Wu said Taiwan health officials began screening passengers arriving from Wuhan and additional early travel restrictions were put in place.
As much of the world waited for more information, Taiwan activated its Central Epidemic Command Center (CECC), which coordinates different ministries in an emergency, and the military was brought in to boost mask and PPE production.
Those initial, early responses to the outbreak in China — and the willingness to take action — were critical in preventing the spread of the virus in Taiwan, potentially saving thousands of lives.
Direct flights from Wuhan, China were monitored from December 31, 2019 and all passengers underwent a health screen.
Taiwan’s Center for Disease Control announced on January 20 it had sent two experts to Wuhan to try and “obtain more comprehensive information of the outbreak.”
One day later, Taiwan confirmed its first reported case of the novel coronavirus. Wuhan residents were banned from entering and all passengers from China, Hong Kong and Macau were screened.
All this happened before Wuhan itself went into lockdown on January 23. And by March, Taiwan banned all foreign nations from entering the island, apart from diplomats, those with resident visas with special entry visas.
Dr. James Wang is the Director of Center for Policy, Outcomes and Prevention at Stanford University said places like Taiwan “tend to act on the conservative side so, when it wasn’t clear how it was spread, they said we’re going to wear a mask anyway and they got it right.”
Another key to success, according to Foreign Minister Wu and outside experts: be honest about the dangers.
Wu said they were giving “daily briefings, every day and sometimes twice a day to brief the population on what was going on in a very transparent way and the people just developed a trust to the government dealing with this matter.”
This trust according to Wu, helped to ensure that masks were worn, hands were washed and quarantines respected.
‘Life here is so surreal’
Taiwan’s early response means everyday life on the island is now very different from a lot of places worldwide where leaders weren’t quick to act.
Sil Chen moved to New York from her native Taiwan 16 years ago to set up a psychotherapy practice.
She thinks she caught the virus mid-March from a client who was coughing during a session. “At the time, people were not taking this very seriously,” said Chen.
Back then, it was also hard to get a test in the US so she stayed in her apartment for five weeks to avoid spreading the virus. An antibody test two months later confirmed her infection.
“I think it was quite mild compared to the other people that I knew but I did cough for two months… and I did not get my smell back for a month,” said Chen.
Chen came back to Taipei mid-July to visit her grandmother who has lung cancer. After a 14-day quarantine, she took her 99-year-old grandmother out and about. “We were dining in a restaurant,” she said, “doing group yoga with people and I was like, wow, this is so surreal, it would not have been possible for me to bring my grandma to a public space like that anywhere else in the world almost.”
From the science of closing to the science of re-opening
Dr. Wang and associates at Stanford have written about the success of the Taiwan model in slowing the virus, but he would like the island to go one step further.
“Taiwan has been really great at the science of closing… but what is the new science of re-opening that could be a good model for the world?” said Wang.
Looking at potential travel corridors or travel bubbles between countries that have handled the pandemic well, Wang suggested introducing a shorter quarantine period, made possible by successive negative tests.
Taiwan introduced a shorter quarantine period for business visitors in June from countries it considers low or medium risk. This requires visitors to undergo a pre-boarding test to prove they are negative within 72 hours of flying, then a test on day five of quarantine, after which they are permitted to leave isolation and self-monitor for the next two weeks.
“They are already doing what I am suggesting for business travelers, special visas, so what’s the logic in not doing it for everybody?” he asked.
Wang said Taiwan’s government is currently considering an international travel study with Stanford to test shorter quarantine periods with more frequent testing. He said travel corridors are a vital way of reviving economies around the world and wants to study travelers arriving in Taiwan to check the efficiency and practicalities of shorter quarantines.
As Wang pointed out, “at one point we still need to reopen the world and even with the vaccine, it’s not 100% protected.”